Leveraging the Laboratory Response Network Model for the Global Health Security Agenda

Abstract

Promoting global health security as an international priority is a challenge; the US Centers for Disease Control and Prevention (CDC) in its Global Health Security Agenda has articulated the importance of accelerating progress toward a world safe and secure from infectious disease threats. The goals are to (1) prevent and reduce the likelihood of outbreaks-natural, accidental, or intentional; (2) detect threats early to save lives; and (3) respond rapidly and effectively using multisectoral, international coordination and communication. Foundational to this agenda is the World Health Organization (WHO) Revised International Health Regulations (IHR) of 2005, which provide the legal framework for countries to strengthen their health systems in order to be able to respond to any public health emergency of international concern. This article proposes leveraging the distributed structure of the US-managed Laboratory Response Network for Biological Threats Preparedness (LRN-B) to develop the core capacity of laboratory testing and to fulfill the laboratory-strengthening component of the Global Health Security Agenda. The LRN model offers an effective mechanism to detect and respond to public health emergencies of international concern.

Detecting Emerging Infectious Diseases: An Overview of the Laboratory Response Network for Biological Threats

“…The LRN for biological threats (LRN-B) is a component of the LRN that comprises sentinel-, reference-, and national-level laboratories. 1 Sentinel laboratories include thousands of private and commercial laboratories that perform routine diagnostic testing services and have the microbiology subspecialty capabilities to perform standardized protocol-driven steps 2 in identifying infectious disease agents. When sentinel laboratories have determined that the causative agent in a specimen cannot be identified and additional testing must occur (rule-out and refer), specimens may be sent to LRN-B reference laboratories.…”

The role of health systems for health security: a scoping review revealing the need for improved conceptual and practical linkages

“…The prioritisation of national interests demonstrated “competing discourses, domestic and international, which emphasize pre-existing political priorities and serve to de-emphasize disease control strategies which break existing norms”, leading to a situation where the securitisation of certain diseases had to reflect “local political, economic and social factors for its character and success” rather than merely reflect epidemiological evidence and public health priorities [ 55 ]. There is, as a result, a strong national security characteristic within the literature analysed, which received consistent critical response, a trend seen throughout all six building blocks, yet coalescing largely around three policy areas of surveillance, pharmaceutical stockpiling, and bioterrorism [ 37 , 57 ].…”

“…The articles related to high income countries (HICs) confirm this concern about the risk of diseases from the Global South spreading globally. Out of the 34 articles referring to Europe and North America, 57% ( n = 18) dealt with the capacity to respond to pandemics [ 54 , 54 , 62 – 65 ], and infectious diseases like Ebola or Zika [ 66 – 73 ], or tuberculosis [ 67 ], with travel medicine services [ 74 ], as well as with actions that are/should be taken internationally to strengthen global health security [ 57 , 75 ].…”

“…technological innovation, multidisciplinary teams, delivery of population health services, and global health security) was also present [ 102 ]. The review revealed considerable attention to the laboratory workforce capacities as the key basis for the promotion of health security [ 57 ], particularly a focus on the capacity to detect infectious diseases like Ebola and Zika (for instance see [ 72 , 103 ]). Initiatives to support capacity building of workforce at this level were also reported, with international initiatives, such as the International Laboratory Capacity Building Program established by the American society for microbiology [ 104 ] highlighted as promoting health security.…”

Evolution of the World Bank Response to Infectious Disease Outbreaks:From a Reactive to a Proactive Approach

“…The WBG is a partner in the Global Health Security Agenda (GHSA) [21] -a five-year multilateral initiativelaunched in February 2014 to coordinate multiple stakeholders to advance a world safe and secure from infectious disease threats. It was endorsed by the G7 in June 2014.…”